The majority of transformed lymphomas have high standardized uptake values (SUVs) on positron emission tomography (PET) scanning similar to diffuse large B-cell lymphoma (DLBCL)

Noy, Ariela; Schöder, Heiko; Gönen, Mithat; Weissler, Matthew; Ertelt, KE; Cohler, Cheryl; Portlock, Carol S.; Hamlin, Paul A.; Yeung, Henry

doi:10.1093/annonc/mdn657

Cited by 144 publications

(99 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other studies using 18 F-FDG in this setting included mixtures of several lymphoma subtypes, and this heterogeneity may have contributed to the lack of consistency of thresholds of highest SUV max or SUV range (9)(10)(11). For example, our median 18 F-FDG highest SUV max for FL (10.9, Table 2) is higher than the threshold of 10 proposed by Schöder et al, excluding indolent lymphoma with a specificity of 81% (9).…”

Section: Discussionmentioning

confidence: 61%

“…Therefore, a high uptake in an indolent lymphoma could support the suspicion of transformation. However, there is a considerable overlap in 18 F-FDG uptake between aggressive and indolent lymphomas, potentially impairing its utility to detect transformation (9)(10)(11). To overcome this problem, alternative tracers might be useful.…”

mentioning

confidence: 99%

“…However, because 18 F-FDG uptake may strongly vary among histologic subtypes of indolent lymphoma (16) and their transformation (10), thresholds of 18 F-FDG uptake (standardized uptake value) to detect transformation may be a function of the subtype.…”

mentioning

confidence: 99%

See 2 more Smart Citations

¹⁸F-FDG or 3′-Deoxy-3′-¹⁸F-Fluorothymidine to Detect Transformation of Follicular Lymphoma

et al. 2015

View full text Add to dashboard Cite

Considering the different treatment strategy for transformed follicular lymphoma (TF) as opposed to follicular lymphoma (FL), diagnosing transformation early in the disease course is important. There is evidence that 18 F-FDG has utility as a biomarker of transformation. However, quantitative thresholds may require inclusion of homogeneous non-Hodgkin lymphoma subtypes to account for differences in tracer uptake per subtype. Moreover, because proliferation is a hallmark of transformation, 3′-deoxy-3′-18 F-fluorothymidine ( 18 F-FLT) might be superior to 18 F-FDG in this setting. To define the best tracer for detection of TF, we performed a prospective a headto-head comparison of 18 F-FDG and 18 F-FLT in patients with FL and TF. Methods: 18 F-FDG and 18 F-FLT PET scans were obtained in 17 patients with FL and 9 patients with TF. We measured the highest maximum standardized uptake value (SUV max ), defined as the lymph node with the highest uptake per patient, and SUV range , defined as the difference between the SUV max of the lymph node with the highest and lowest uptake per patient. To reduce partial-volume effects, only lymph nodes larger than 3 cm 3 (A50 isocontour) were analyzed. Scans were acquired 1 h after injection of 185 MBq of 18 F-FDG or 18 F-FLT. To determine the discriminative ability of SUV max and SUV range of both tracers for TF, receiver-operatingcharacteristic curve analysis was performed. Results: The highest SUV max was significantly higher for TF than FL for both 18 F-FDG and 18 F-FLT (P , 0.001). SUV range was significantly higher for TF than FL for 18 F-FDG (P 5 0.029) but not for 18 F-FLT (P 5 0.075). The ability of 18 F-FDG to discriminate between FL and TF was superior to that of 18 F-FLT for both the highest SUV max (P 5 0.039) and the SUV range (P 5 0.012). The cutoff value for the highest SUV max of 18 F-FDG aiming at 100% sensitivity with a maximum specificity was found to be 14.5 (corresponding specificity, 82%). For 18 F-FLT, these values were 5.1 and 18%, respectively. When the same method was applied to SUV range , the cutoff values were 5.8 for 18 F-FDG (specificity, 71%) and 1.5 for 18 F-FLT (specificity, 36%). Conclusion: Our data suggest that 18 F-FDG PET is a better biomarker for TF than 18 F-FLT PET. The proposed thresholds of highest SUV max and SUV range should be prospectively validated.

show abstract

Section: Discussionmentioning

confidence: 61%

mentioning

confidence: 99%

See 1 more Smart Citation

¹⁸F-FDG or 3′-Deoxy-3′-¹⁸F-Fluorothymidine to Detect Transformation of Follicular Lymphoma

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Biopsies to confirm this should be directed to the site of greatest FDG avidity. 58 PET can also be helpful in identifying sites of lymphoma that are not clinically evident or clearly appreciated with use of other imaging modalities. For example, FDG PET/CT is helpful in diagnosing malignant involvement of the peripheral nerves, especially when findings from anatomic imaging (magnetic resonance imaging or CT) are negative.…”

Section: Searching For Transformation or To Direct Biopsiesmentioning

confidence: 99%

Positron Emission Tomographic Scans in Lymphoma: Convention and Controversy

Ansell

Armitage

2012

Mayo Clinic Proceedings

View full text Add to dashboard Cite

The use of sensitive and specific imaging techniques for accurate initial staging and evaluation of response to therapy in patients with lymphoma is essential for their optimal management. Fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) integrated with computed tomography (CT) has emerged as a powerful imaging tool and is being routinely used in staging, response evaluation, and posttreatment surveillance in patients with non-Hodgkin lymphoma and Hodgkin lymphoma. PET/CT is currently widely used in clinical practice, but the established clinical benefit is currently restricted to the posttreatment evaluation of Hodgkin lymphoma, diffuse large B-cell lymphoma, and follicular lymphoma. Although used in other histologic subtypes and in other clinical situations including response assessment, its impact on patient outcome remains to be demonstrated. We performed a literature search of PubMed from 1999 to 2011 using the following keywords: PET scan, FDG-PET, PET/CT, lymphoma. This review addresses the challenges and controversies in the use of PET/CT scans in the management of patients with lymphoma. I n most patients with lymphoma, positron emission tomographic (PET) scans show abnormalities at diagnosis. Normal findings on the scan after therapy is highly predictive of a good prognosis, particularly in patients with diffuse large B-cell lymphoma (DLBCL), follicular lymphoma, and Hodgkin lymphoma. However, the optimal application of PET scans to the management of all patients with lymphoma remains problematic. The major controversies include the optimal timing of PET scans (for staging, during therapy, after completion of therapy, surveillance in remission), standardization of PET scan interpretation (visual interpretation compared with standard uptake value [SUV] calculation), what constitutes a positive PET scan result, and whether PET scans should be used to direct management (eg, does changing therapy in patients with positive findings on PET change outcome, should biopsies of sites with positive PET results be done routinely before a management change). Although a large body of literature addressing these topics exists, the studies are often difficult to compare, making definitive conclusions on all these issues difficult. The previously published studies often used different designs and variable reporting, making interpretation and comparison of the results difficult. In the early studies particularly, heterogeneous populations with different stages of disease and different histologic subtypes were included, making the clinical applicability of the studies' results difficult. More recent studies focusing on efforts to standardize the conduct and interpretation of PET scans and on riskadapted therapies based on interim PET scan results will, it is hoped, improve the management and outcome of patients with lymphoma. A literature search of PubMed from 1999 to 2011 was performed using the following keywords: PET scan, FDG-PET, PET/CT, lymphoma. We highlight the current standard use ...

show abstract

“…of lesions detectable by 18 FDG-PET is highly sensitive in excluding RS, with a negative predictive value of up to 97%, the positive predictive value of 18 FDG-PET/CT for RS is generally proportional to the SUV; an SUV > 10 is predictive of the presence of aggressive lymphoma with 80% confidence, and an SUV > 13 with >90% confidence [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Histologic transformation of chronic lymphocytic leukemia/small lymphocytic lymphoma

et al. 2016

View full text Add to dashboard Cite

Although generally considered a clinically indolent neoplasm, CLL/SLL may undergo transformation to a clinically aggressive lymphoma. The most common form of transformation, to DLBCL, is also known as Richter syndrome. Transformation determines the course of the disease and is associated with unfavorable patient outcome. Precise detection of transformation and identification of predictive biomarkers and specific molecular pathways implicated in the pathobiology of transformation in CLL/SLL will enable personalized therapeutic approach and provide potential avenues for improving the clinical outcome of patients. In this review, we present an overview of the pathologic features, risk factors, and pathogenic mechanisms of CLL/ SLL transformation.

show abstract

The majority of transformed lymphomas have high standardized uptake values (SUVs) on positron emission tomography (PET) scanning similar to diffuse large B-cell lymphoma (DLBCL)

Cited by 144 publications

References 12 publications

¹⁸F-FDG or 3′-Deoxy-3′-¹⁸F-Fluorothymidine to Detect Transformation of Follicular Lymphoma

¹⁸F-FDG or 3′-Deoxy-3′-¹⁸F-Fluorothymidine to Detect Transformation of Follicular Lymphoma

Positron Emission Tomographic Scans in Lymphoma: Convention and Controversy

Histologic transformation of chronic lymphocytic leukemia/small lymphocytic lymphoma

Contact Info

Product

Resources

About

The majority of transformed lymphomas have high standardized uptake values (SUVs) on positron emission tomography (PET) scanning similar to diffuse large B-cell lymphoma (DLBCL)

Cited by 144 publications

References 12 publications

18F-FDG or 3′-Deoxy-3′-18F-Fluorothymidine to Detect Transformation of Follicular Lymphoma

18F-FDG or 3′-Deoxy-3′-18F-Fluorothymidine to Detect Transformation of Follicular Lymphoma

Positron Emission Tomographic Scans in Lymphoma: Convention and Controversy

Histologic transformation of chronic lymphocytic leukemia/small lymphocytic lymphoma

Contact Info

Product

Resources

About

¹⁸F-FDG or 3′-Deoxy-3′-¹⁸F-Fluorothymidine to Detect Transformation of Follicular Lymphoma

¹⁸F-FDG or 3′-Deoxy-3′-¹⁸F-Fluorothymidine to Detect Transformation of Follicular Lymphoma